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The National Consumer Voice for Quality Long-Term Care

June 19, 2012

Overview of the Supreme Court Case on the Affordable Care Act

As we await the Supreme Court’s imminent decision on the constitutionality of the Affordable Care Act, here is a brief overview outlining the fundamentals of the case:

There are two groups of plaintiffs in the case: 1) 26 states, led by Florida; and 2) the National Federation of Independent Business and individuals plaintiffs. The defendant in the case is the US Department of Health and Human Services, Treasury, and Labor. It should be noted that the progression of this case, from commencing the suit in March 2010 to issuing a decision (presumably) in June 2012 has been extremely fast. 

There are four main issues of the case that the Supreme Court will ultimately decide:

1.) Do courts have jurisdiction to decide the constitutionality of the ACA’s individual mandate provision right now?
2.) If so, is the ACA’s individual mandate provision constitutional?
3.) If unconstitutional, is the individual mandate provision severable, which means will other parts of the law be able to survive without it?
4.) Is the ACA’s Medicaid expansion constitutional? No matter what the court decides about the individual mandate, it’s expected that we will receive a definitive ruling on this.

For the first issue, HHS is arguing that the court does not have jurisdiction to hear the case yet because of the Anti-Injunction Act (AIA), which means that you cannot challenge a tax until it’s assessed and due. Since the individual mandate does not come into play until 2014, HHS is arguing it’s too soon to rule on this issue. 

For the second issue, HHS is arguing three different grounds of constitutionality of the individual mandate: the Commerce Clause, the Necessary and Proper Clause, and the Tax Clause. The Supreme Court only needs to rule in favor of one of these for the mandate to be found constitutional.

For the third issue, Congress will be deciding whether the rest of the law still functions without the individual mandate, as well as whether Congress still would have enacted the rest of the law if it knew the mandate would be struck down. If the Court decides the mandate is not severable from the rest of the law, it will invalidate the entire ACA. If the Court decides the mandate is severable, the Court could strike just the mandate, or the Court could also strike the guaranteed issue and community rating provisions.

For the fourth issue, whether the Medicaid Expansion can be upheld, the states are arguing an argument based on coercion. They’re basically saying that their state budgets are so entwined in the Medicaid system that there is no way they cannot accept the Medicaid funds, therefore for HHS to say that they need to expand the mandatory groups that Medicaid will cover as well the mandatory groups that are being covered is actually coercion because HHS knows that the states are not in a position to refuse. If the Court decides the Medicaid expansion is not severable, it invalidates the entire ACA. If the Court decides the Medicaid expansion is severable, the Court could strike down just the Medicaid expansion or strike the Medicaid expansion and other provisions of the ACA.

To sum it up, here is a list of what’s at stake for health care reform in the Supreme Court:

1.) Individual Mandate
2.) Medicaid Eligibility Expansion
3.) Entire ACA, including: health insurance marking reforms, health insurance exchanges, employer responsibility provisions, tax subsidies for premiums and cost-sharing, Medicare benefits expansion, payment reductions, delivery system reforms (ACOs, etc.), Public Health and Prevention Fund, health care workforce expansions, and transparency and program integrity provisions

We’ll have additional coverage on the Supreme Court’s decision and how this could impact long-term care consumers – be on the lookout!

In addition, visit Consumer Voice’s website to view a page laying out pertinent provisions of the ACA.

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Consumer Voice's Robyn Grant Participates in Forum Hosted by Senate Special Committee on Aging

Last Wednesday, June 13th, the Consumer Voice was proud to have Robyn Grant, Director of Public Policy & Advocacy, participate in a forum hosted by the Senate Special Committee on Aging on ‘Advancing Practices for Raising the Bar for the Senior Care Leaders’. The forum brought together leading figures from the long-term care administrator field and health management academia, as well as policy leaders from the Center for Medicare and Medicaid Services (CMS) and the Senate to discuss how to elevate the standards and practices of nursing home and other long-term care facility administrators. The Consumer Voice’s participation in the forum allowed for the unique perspective of consumers on these issues to be represented, specifically what aspects long-term care consumers feel to be essential in a quality administrator. The forum reached consensus on the need to implement more rigorous standards administrators, as currently some states only require individuals to be eighteen years of age and in possession of a high school diploma to become an administrator of a long-term care facility. The Consumer Voice looks forward to working with leaders in the health management field to further examine what could be done to improve administrator standards.

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White House World Elder Abuse Awareness Day Commemoration

On June 14 the White House Office of Public Engagement held a day-long symposium on Elder Abuse & Financial Exploitation. This event, hosted in collaboration with the Administration for Community Living/Department of Health and Human Services, the Consumer Financial Protection Bureau, and the Department of Justice, brought together partners and elder abuse experts from around the country to discuss preventing and responding to financial exploitation. Featured speakers included representatives from the federal government, the banking industry, and national elder abuse experts. Several federal initiatives were announced including:

·         Creation of an Elder Justice Coordinating Council (Department of Health & Human Services) comprised of federal agencies that have responsibilities or programs related to elder abuse, neglect, and exploitation, who will work to address the cross-agency coordination of activities relating to elder abuse, neglect and exploitation.

·         The Missing Link Project (Department of Justice) which will develop training materials for legal services attorneys

·         A public inquiry to learn more about the many ways in which older Americans are financially exploited and about the best practices for elder financial management (Consumer Financial Protection Bureau)

·         An initiative to protect individual personal identifying information and a “centarian review” initiative (Social Security Administration).

A new coalition was launched at the event, the Ageless Alliance United Against Elder Abuse, a grassroots movement connecting people of all age groups to identify, prevent and eliminate elder abuse.

For more information, including the video from the day, visit NORC's website.

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President Proclaims June 15, 2012 World Elder Abuse Awareness Day

In a presidential proclamation, President Obama proclaimed June 15, 2012 as World Elder Abuse Awareness Day. He called upon all Americans to observe June 15th by learning about elder abuse and by raising awareness about the issue.

Read the president’s full proclamation on the White House website.

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Secretary Sebelius Announces Funding to Prevent Elder Abuse

Health and Human Services (HHS) Secretary Kathleen Sebelius announced a $5.5 million funding opportunity for states to test ways to prevent elder abuse, neglect and exploitation. She announced the initiative at a White House Elder Abuse Awareness Day commemoration, saying “we need to be on the look-out for elder abuse and act when we see it. Today we are sending a clear message that elder abuse will not be tolerated or kept in the shadows.”

For more information, read the news release.

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Join ALCA for a Webinar on Financial Elder Abuse Scams

Join Assisted Living Consumer Alliance (ALCA) for “What could that FREE lunch cost you? – How to Avoid Being Drawn into Financial Elder Abuse Scams”. This webinar will address various scams, unsuitable annuities and other financial schemes that target seniors living in assisted living facilities. It will also discuss civil and criminal liability for assisted living facilities when they open their doors to financial predators.

What could that FREE lunch cost you? - How to Avoid Being Drawn into Financial Elder Abuse Scams
Wednesday, June 27, 2012
2:00pm - 3:00pm EST

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About The Gazette

The Gazette is a weekly e-newsletter, published by the National Consumer Voice for Quality Long-Term Care and the National Long-Term Care Ombudsman Resource Center. If you do not wish to continue receiving this publication, please unsubscribe. Your contributions and comments are welcome and should be sent to swells@theconsumervoice.org. Copyright © 2011.

The Consumer Voice is the leading national voice representing consumers in issues related to long-term care, helping to ensure that consumers are empowered to advocate for themselves. We are a primary source of information and tools for consumers, families, caregivers, advocates and ombudsmen to help ensure quality care for the individual. The Consumer Voice's mission is to represent consumers at the national level for quality long-term care, services and supports.

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